妊娠期糖尿病孕妇血清及胎盘组织ANGPTL6、PTX3水平变化及检测意义  

Changes and detection significance of serum and placental tissue levels of ANGPTL6 and PTX3 in pregnant women with gestational diabetes mellitus

作　　者：宋芳静 韩秋峪 许文青 李欣悦 SONG Fangjing;HAN Qiuyu;XU Wenqing;LI Xinyue(Xuzhou Medical University,Xuzhou 221004,China;Department of Obstetrics and Gynecology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China)

机构地区：[1]徐州医科大学,江苏徐州221004 [2]徐州医科大学附属医院妇产科,江苏徐州221002

出　　处：《陕西医学杂志》2025年第2期192-196,共5页Shaanxi Medical Journal

基　　金：江苏省妇幼健康科研项目(F202041)。

摘　　要：目的:探讨妊娠期糖尿病(GDM)孕妇血清及胎盘组织血管生成素样蛋白6(ANGPTL6)、正五聚蛋白3(PTX3)水平变化及检测意义。方法:选取经阴分娩的GDM孕妇60例,根据控制血糖方式不同将患者分为经饮食和运动血糖控制良好组(G1组)和经胰岛素治疗血糖控制良好组(G2组),各30例。另选取同期经阴分娩的健康孕妇30例为对照组(N组)。收集三组孕妇分娩前空腹血清以及分娩后胎盘组织样本,采用ELISA法检测血清ANGPTL6、PTX3水平,RT-qPCR检测胎盘组织ANGPTL6、PTX3表达水平。用Pearson法分析GDM患者血清及胎盘组织ANGPTL6、PTX3水平与糖脂代谢指标的相关性。记录GDM孕妇的妊娠结局,分为结局良好组(47例)和结局不良组(13例)。ROC曲线分析血清ANGPTL6、PTX3对GDM患者不良妊娠结局的预测价值。结果:G2和G1组血清空腹血糖(FBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血清及胎盘组织ANGPTL6、PTX3水平高于N组,且G2组高于G1组(均P<0.05)。G2和G1组血清高密度脂蛋白胆固醇(HDL-C)水平低于N组,且G2组低于G1组(均P<0.05)。GDM患者血清及胎盘组织ANGPTL6、PTX3水平与血清FBG、HbA1c、HOMA-IR水平呈正相关(均P<0.05)。与妊娠结局良好组比较,不良组血清以及胎盘组织ANGPTL6、PTX3水平升高(均P<0.05)。血清ANGPTL6和PTX3两者联合预测的曲线下面积(AUC)大于单独指标预测的AUC(均P<0.05)。结论:GDM孕妇血清及胎盘组织ANGPTL6、PTX3水平升高,与糖脂代谢及妊娠结局有关,两者联合对患者不良妊娠结局有一定预测价值。Objective:To investigate the changes and detection significance of serum and placental tissue levels of angiopoietin-like protein 6(ANGPTL6)and pentraxin 3(PTX3)in pregnant women with gestational diabetes mellitus(GDM).Methods:A total of 60 GDM pregnant women who delivered via vaginal delivery were selected and divided into two groups based on blood glucose control methods:Group G1 with well-controlled blood glucose through diet and exercise,and Group G2 with well-controlled blood glucose through insulin therapy,each consisting of 30 cases.Additionally,30 healthy pregnant women with vaginai delivery during the same period were selected as the control group(Group N).Fasting serum samples and placental tissue samples were collected from the three groups of pregnant women before delivery.ELISA was used to detect serum levels of ANGPTL6 and PTX3,and RT-qPCR was used to detect the expression levels of ANGPTL6 and PTX3 in placental tissue.Pearson’s correlation analysis was applied to assess the correlation between serum and placental tissue levels of ANGPTL6 and PTX3 and glycometabolic indicators in GDM patients.The pregnancy outcomes of GDM pregnant women were recorded and divided into a favorable outcome group(47 cases)and an adverse outcome group(13 cases).ROC curve was used to analyze the predictive value of serum ANGPTL6 and PTX3 for adverse pregnancy outcomes in GDM patients.Results:The levels of fasting blood glucose(FBG),glycated hemoglobin(HbA1c),insulin resistance index(HOMA-IR),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C)and serum and placental tissue levels of ANGPTL6 and PTX3 in Groups G2 and G1 were higher than those in Group N,and Group G2 was higher than Group G1(all P<0.05).The levels of high-density lipoprotein cholesterol(HDL-C)in Groups G2 and G1 were lower than those in Group N,and Group G2 was lower than Group G1(all P<0.05).The levels of ANGPTL6 and PTX3 in serum and placental tissue of GDM patients were positively correlated with serum levels of FBG,HbA1c

关 键 词：妊娠期糖尿病 血管生成素样蛋白6 正五聚蛋白3 糖脂代谢 妊娠结局 预测价值 

分 类 号：R714.25[医药卫生—妇产科学]